Further waves of vCJD predicted 22 February 2010
22 February 2010
email@example.com Variant Creutzfeldt-Jakob Disease (vCJD) remains a ‘very real and continuing threat’ to public health and recent developments strongly support predictions of second and third waves of long incubation vCJD, an international expert has warned.
Dr Robert Rohwer, Associate Professor of Neurology at the University of Maryland, Baltimore, told a patient safety conference in London earlier this month (February 4) that vCJD-contaminated blood posed the greatest risk for human-to-human transmission of the disease.
“Moreover, since the transmission is between humans rather than bovine to human and the exposure is by transfusion or injection rather than orally, it is expected to be at least 1,000 times more efficient than transmissions from BSE-infected food,” he stated.
Dr Rohwer stressed that this was not a theoretical risk. “To date there have been five recognised cases of transfusion transmission of vCJD and one highly probable transmission from a plasma product.
“It is not known how many donors are incubating vCJD, but accumulating evidence of long incubation times in genotypes that make up approximately two thirds of the population intimates that it may be far greater than indicated by the cases detected to date.”’
The incidence of vCJD in Ireland is second to that of the UK, and ahead of France — the countries hardest hit by the disease.
In December, research by Prof John Collinge of the National Prion Clinic, published in The Lancet (Vol.374. Issue 9707, p2128), described the first patient to succumb to vCJD from a previously unaffected genetic subgroup of the prion protein. This finding strengthens an earlier prediction of second and third waves of vCJD in people who were infected over the same period as those in the first wave, but whose genetics result in a longer incubation time. Two thirds of the population is in this group, and many may be spreading the infection through blood and tissue donations.
Stressing the ‘significant challenges’ of detecting the prion in blood, Dr Rohwer urged implementation of proven infectivity removal technologies – such as prion filtration — to protect the blood supply.
The Department of Health in Ireland has not followed the independent expert advice of the Advisory Committee on the Safety of Blood, Tissues and Organs in the UK, which has advised the Department’s counterpart in Britain to start filtering blood for children.
Chief Medical Officer Dr Tony Holohan has, however, asked the Health Information and Quality Authority (HIQA) to carry out an assessment of the new technology.
Posted in News on 22 February 2010
Friday, February 05, 2010
New Variant Creutzfelt Jakob Disease case reports United States 2010 A Review
Friday, February 19, 2010
Creutzfeldt-Jakob disease (CJD) biannual update (2010/1)
4.49 pm Clause 2 : Blood donations
Moved by Baroness Masham of Ilton
1: Clause 2, page 2, line 22, at end insert "the blood supply is made safe through the implementation of prion filtration and that"
Baroness Masham of Ilton: My Lords, the noble Lord, Lord Morris of Manchester, is president of the Haemophilia Society and I am a vice-president. We both feel that blood safety is an absolute priority, particularly for the groups of people who rely on a regular supply of clean, safe blood. I congratulate the noble Lord, Lord Morris, and the noble and learned Lord, Lord Archer of Sandwell, on their tireless efforts in championing the rights of people with haemophilia.
Amendment 1 aims to make a minor change to Part 2 of the Bill regarding the measures that need to be introduced to ensure that people with haemophilia are not given contaminated blood or blood products in the future. The amendment seeks to ensure that all diseases are covered by widening the potential range of solutions to blood diseases that can be used.
The current wording of the Bill proposes that people with haemophilia are offered a blood test for a list of conditions including hepatitis B, hepatitis C, syphilis and variant Creutzfeldt-Jakob disease-variant CJD. The challenge is that at present there is not a reliable blood test for variant CJD, unlike for other viral infections and blood-borne diseases. Detecting the infective prion that causes variant CJD is extremely difficult and as yet no one has been able to develop a test that would be reliable or effective.
However, an alternative approach to a blood test has been developed to ensure that all donated blood is free from the infective prion that causes variant CJD. This approach, prion filtration, effectively cleans the blood removing all prion whether infective or not. The P-CAPT filter has been designed to work directly with the existing technologies used by the UK National Blood Service and has been CE marked since 2006, meaning that it has passed EU-wide safety and efficacy testing, as required for it to be legally used in the UK.
In October, the Government's blood safety advisory body, SaBTO-the Advisory Committee on Safety of Blood Tissues and Organs-published advice stating that there is now sufficient evidence that the P-CAPT prion reduction filter reduces infectivity and successfully cleans blood to remove the infective prions that carry variant CJD.
The haemophilia group has had a really terrible time with HIV infection, hepatitis C and variant CJD and the risk of it. We must surely do all that we can
21 Jan 2010 : Column 1181
to protect those people. I am pleased that the noble Lord, Lord Morris of Manchester, my colleague of many years over matters relating to disability, is supporting this amendment. I wish the Bill godspeed and I beg to move.
Lord Morris of Manchester: My Lords, I am most grateful to my good friend the noble Baroness, Lady Masham of Ilton, for proposing this important amendment. As she said, we have worked in close rapport for over 40 years to enhance the status and improve the well-being of chronically ill and disabled people-she made her maiden speech on the Bill I enacted in 1970-which of course makes this an evocative moment for us both.
I diverge from her only very slightly today. She said before the debate that she was sure she was pushing an open door. In fact my door is off its hinges and I was delighted to add my name to hers as a signatory of this amendment. Thus I can be brief in my response, pointing as the noble Baroness did, to the emphasis placed in my speech on 17 March on the importance of prion filtration in removing the causative agent of variant CJD.
This debate takes place against a backcloth of human suffering on a scale that most people can barely imagine. A small and stricken community of barely 5,000 people, already disabled by a rare, lifelong blood disorder, haemophilia patients have twice been infected en masse by contaminated NHS blood and blood products. Ninety-five per cent of them were infected with hepatitis C, and one in four with HIV. Of the 1,243 haemophilia patients infected with HIV, only 361-29 per cent-are still alive. The much higher number of deaths among the hepatitis C-infected patients is still increasing.
As of now, an estimated 1,974 haemophilia patients have died from being infected in the worst ever treatment disaster in the history of the National Health Service. Should anyone dispute that assessment, they should look at the finding of distinguished statisticians that the contaminated blood disaster involved the haemophilia community in a loss of life more savage in proportion to the number of people at risk than the Black Death.
It is in that context that the sombre new threat of a third scourge facing the haemophilia community must be judged. Many hundreds of haemophilia patients have now been told by the Department of Health that they were prescribed blood from donors who subsequently died of variant CJD; indeed, a post-mortem on one such victim found variant CJD in his spleen.
The amendment addresses the new scourge and plainly warrants the support of this House.
Amendment 1 agreed.
Clause 6 : Regulations, short title, commencement and extent
Moved by Lord Morris of Manchester
2: Clause 6, page 4, line 5, leave out subsection (1) and insert-
"(1) Regulations made by the Secretary of State under this Act are to be made by statutory instrument.
Saturday, December 12, 2009
103RD MEETING OF THE SPONGIFORM ENCEPHALOPATHY ADVISORY COMMITTEE
1: J Neurol Neurosurg Psychiatry 1994 Jun;57(6):757-8
Transmission of Creutzfeldt-Jakob disease to a chimpanzee by electrodes contaminated during neurosurgery.
Gibbs CJ Jr, Asher DM, Kobrine A, Amyx HL, Sulima MP, Gajdusek DC.
Laboratory of Central Nervous System Studies, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892.
Stereotactic multicontact electrodes used to probe the cerebral cortex of a middle aged woman with progressive dementia were previously implicated in the accidental transmission of Creutzfeldt-Jakob disease (CJD) to two younger patients. The diagnoses of CJD have been confirmed for all three cases. More than two years after their last use in humans, after three cleanings and repeated sterilisation in ethanol and formaldehyde vapour, the electrodes were implanted in the cortex of a chimpanzee. Eighteen months later the animal became ill with CJD. This finding serves to re-emphasise the potential danger posed by reuse of instruments contaminated with the agents of spongiform encephalopathies, even after scrupulous attempts to clean them.
Sunday, January 17, 2010
Human tissue, recovered from a donor history indicated increased risk factors for Creutzfeldt-Jacob disease Lions Eye Bank
Saturday, January 16, 2010 Evidence For CJD TSE Transmission Via Endoscopes 1-24-3 re-Singeltary to Bramble et al
Friday, November 20, 2009
SaBTO Advisory Committee on the Safety of Blood, Tissues and Organs Summary of the Eighth Meeting, 27 October 2009
Sunday, May 10, 2009
Meeting of the Transmissible Spongiform Encephalopathies Committee On June 12, 2009 (Singeltary submission)
Monday, August 17, 2009
Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Annex J,K, AND D Published: 2009
Friday, July 17, 2009
Revision to pre-surgical assessment of risk for vCJD in neurosurgery and eye surgery units Volume 3 No 28; 17 July 2009
Tuesday, August 12, 2008
Biosafety in Microbiological and Biomedical Laboratories Fifth Edition 2007 (occupational exposure to prion diseases)
Sunday, August 09, 2009
CJD...Straight talk with...James Ironside...and...Terry Singeltary... 2009
Tuesday, August 18,
2009 BSE-The Untold Story - joe gibbs and singeltary 1999 - 2009
Saturday, January 2, 2010
Human Prion Diseases in the United States January 1, 2010 ***FINAL***
my comments to PLosone here ;
Friday, January 22, 2010 nvCJD Clause 2 : Blood donations
18.173 page 189
Experimental Challenge of Cattle with H-type and L-type Atypical BSE
A. Buschmann1, U. Ziegler1, M. Keller1, R. Rogers2, B. Hills3, M.H. Groschup1. 1Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany, 2Health Canada, Bureau of Microbial Hazards, Health Products & Food Branch, Ottawa, Canada, 3Health Canada, Transmissible Spongiform Encephalopathy Secretariat, Ottawa, Canada
Background: After the detection of two novel BSE forms designated H-type and L-type atypical BSE the question of the pathogenesis and the agent distribution of these two types in cattle was fully open. From initial studies of the brain pathology, it was already known that the anatomical distribution of L-type BSE differs from that of the classical type where the obex region in the brainstem always displays the highest PrPSc concentrations. In contrast in L-type BSE cases, the thalamus and frontal cortex regions showed the highest levels of the pathological prion protein, while the obex region was only weakly involved.
Methods:We performed intracranial inoculations of cattle (five and six per group) using 10%brainstemhomogenates of the two German H- and L-type atypical BSE isolates. The animals were inoculated under narcosis and then kept in a free-ranging stable under appropriate biosafety conditions.At least one animal per group was killed and sectioned in the preclinical stage and the remaining animals were kept until they developed clinical symptoms. The animals were examined for behavioural changes every four weeks throughout the experiment following a protocol that had been established during earlier BSE pathogenesis studies with classical BSE.
Results and Discussion: All animals of both groups developed clinical symptoms and had to be euthanized within 16 months. The clinical picture differed from that of classical BSE, as the earliest signs of illness were loss of body weight and depression. However, the animals later developed hind limb ataxia and hyperesthesia predominantly and the head. Analysis of brain samples from these animals confirmed the BSE infection and the atypical Western blot profile was maintained in all animals. Samples from these animals are now being examined in order to be able to describe the pathogenesis and agent distribution for these novel BSE types. Conclusions: A pilot study using a commercially avaialble BSE rapid test ELISA revealed an essential restriction of PrPSc to the central nervous system for both atypical BSE forms. A much more detailed analysis for PrPSc and infectivity is still ongoing.
To: Terry Singeltary
Sent: Saturday, December 05, 2009 9:09 AM
Subject: 14th ICID - abstract accepted for 'International Scientific Exchange'
Your preliminary abstract number: 670
Dear Mr. Singeltary,
On behalf of the Scientific Committee, I am pleased to inform you that your abstract
'Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America update October 2009'
WAS accepted for inclusion in the INTERNATIONAL SCIENTIFIC EXCHANGE (ISE) section of the 14th International Congress on Infectious Diseases. Accordingly, your abstract will be included in the "Intl. Scientific Exchange abstract CD-rom" of the Congress which will be distributed to all participants.
Abstracts accepted for INTERNATIONAL SCIENTIFIC EXCHANGE are NOT PRESENTED in the oral OR poster sessions.
Your abstract below was accepted for: INTERNATIONAL SCIENTIFIC EXCHANGE
#0670: Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America update October 2009
Author: T. Singeltary; Bacliff, TX/US
Topic: Emerging Infectious Diseases Preferred type of presentation: International Scientific Exchange
This abstract has been ACCEPTED.
#0670: Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America update October 2009
Authors: T. Singeltary; Bacliff, TX/US
Title: Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America update October 2009
An update on atypical BSE and other TSE in North America. Please remember, the typical U.K. c-BSE, the atypical l-BSE (BASE), and h-BSE have all been documented in North America, along with the typical scrapie's, and atypical Nor-98 Scrapie, and to date, 2 different strains of CWD, and also TME. All these TSE in different species have been rendered and fed to food producing animals for humans and animals in North America (TSE in cats and dogs ?), and that the trading of these TSEs via animals and products via the USA and Canada has been immense over the years, decades.
12 years independent research of available data
I propose that the current diagnostic criteria for human TSEs only enhances and helps the spreading of human TSE from the continued belief of the UKBSEnvCJD only theory in 2009. With all the science to date refuting it, to continue to validate this old myth, will only spread this TSE agent through a multitude of potential routes and sources i.e. consumption, medical i.e., surgical, blood, dental, endoscopy, optical, nutritional supplements, cosmetics etc.
I would like to submit a review of past CJD surveillance in the USA, and the urgent need to make all human TSE in the USA a reportable disease, in every state, of every age group, and to make this mandatory immediately without further delay. The ramifications of not doing so will only allow this agent to spread further in the medical, dental, surgical arena's. Restricting the reporting of CJD and or any human TSE is NOT scientific. Iatrogenic CJD knows NO age group, TSE knows no boundaries.
I propose as with Aguzzi, Asante, Collinge, Caughey, Deslys, Dormont, Gibbs, Gajdusek, Ironside, Manuelidis, Marsh, et al and many more, that the world of TSE Transmissible Spongiform Encephalopathy is far from an exact science, but there is enough proven science to date that this myth should be put to rest once and for all, and that we move forward with a new classification for human and animal TSE that would properly identify the infected species, the source species, and then the route.
Keywords: Transmissible Spongiform Encephalopathy Creutzfeldt Jakob Disease Prion
Monday, October 19, 2009
Atypical BSE, BSE, and other human and animal TSE in North America Update October 19, 2009
I ask Professor Kong ;
Thursday, December 04, 2008 3:37 PM Subject: RE: re--Chronic Wating Disease (CWD) and Bovine Spongiform Encephalopathies (BSE): Public Health Risk Assessment
''IS the h-BSE more virulent than typical BSE as well, or the same as cBSE, or less virulent than cBSE? just curious.....''
Professor Kong reply ;
''As to the H-BSE, we do not have sufficient data to say one way or another, but we have found that H-BSE can infect humans. I hope we could publish these data once the study is complete.
Thanks for your interest.''
Qingzhong Kong, PhD Associate Professor Department of Pathology Case Western Reserve University Cleveland, OH 44106 USA
I look forward to further transmission studies, and a true ENHANCED BSE/atypical BSE surveillance program put forth testing all cattle for human and animal consumption for 5 years. a surveillance program that uses the most sensitive TSE testing, and has the personnel that knows how to use them, and can be trusted. I look forward to a stringent mad cow feed ban being put forth, and then strictly enforced. we need a forced, not voluntary feed ban, an enhanced feed ban at that, especially excluding blood. we need some sort of animal traceability. no more excuses about privacy. if somebody is putting out a product that is killing folks and or has the potential to kill you, then everybody needs to know who they are, and where that product came from. same with hospitals, i think medical incidents in all states should be recorded, and made public, when it comes to something like a potential accidental transmission exposure event. so if someone is out there looking at a place to go have surgery done, if you have several hospitals having these type 'accidental exposure events', than you can go some place else. it only makes sense. somewhere along the road, the consumer lost control, and just had to take whatever they were given, and then charged these astronomical prices. some where along the line the consumer just lost interest, especially on a long incubating disease such as mad cow disease i.e. Transmissible Spongiform Encephalopathy. like i said before, there is much more to the mad cow story than bovines and eating a hamburger, we must start focusing on all TSE in all species. ...TSS
full text ;
Friday, January 29, 2010 14th International Congress on Infectious Diseases H-type and L-type Atypical BSE January 2010 (special pre-congress edition)